Gina Elizabeth Hernandez, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1401 Issued in OK

Practice address

1104 Walnut Dr
Ardmore, OK 73401-2353

Phone

(580) 226-0543

Fax

(580) 226-2284

NPI assigned

Jul 22, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Oklahoma State University College of Osteopathic Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Shepherd Community Clinic, Inc.Group PAC ID 4284936337, 19 clinicians

Triad Complete Healthcare A12 LLCGroup PAC ID 8820512247, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ideal Home Care, L.P. Home health agency, Ardmore, OK, CCN 377678
• Mercy Hospital Ardmore, Inc Hospital, Ardmore, OK, CCN 370047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gina.hernandez-roberts.1@21725.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Good Shepherd Community Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ardmore, OK
  • NPI 1285010413
  Medicare reassignment Care Compare group
• Triad Complete Healthcare A12 LLC

  • Family Medicine Physician
  • Ardmore, OK
  • NPI 1891506960
  Medicare reassignment Care Compare group
• Mercy Hospital Ardmore, Inc.

  • General Acute Care Hospital
  • Ardmore, OK
  • NPI 1386741635
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ideal Home Care, LLC

  • Home Health Agency
  • Ardmore, OK
  • NPI 1467430595
  Care Compare affiliation
• Mercy Hospital Ardmore, Inc.

  • General Acute Care Hospital
  • Ardmore, OK
  • NPI 1386741635
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1760403943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-226-0543",
            "fax_number": "580-226-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "GINA",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200061330A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry Roberts Express Pharmacy LLC
• Henry Roberts Express Pharmacy LLC
• Hayden D. Henry, M.D.
• Kala Lee Hensley
• Jamie Hepler
• Teresa Marie Hernandez
• Dana Michelle Herring, FNP
• Kelly Herrod
• Joel Herschler, DDS
• Brandi Hicks, FSP

• Physician Assistant in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.